Measuring charge and mass distributions in dry powder inhalers using the electrical Next Generation Impactor (eNGI)

The electrical Next Generation Impactor (eNGI) was assessed against the electrical low-pressure impactor (ELPI) and next generation impactor (NGI) for its capability to characterise particle size and electrostatic charge properties of dry powder inhaler (DPI) formulations. Following assessment, the relationship between inhalational air flow rate and drug powder charge was explored using the eNGI. At a vacuum flow rate of 30 L/min, doses of Pulmicort^® (budesonide 400 μg) and Bricanyl^® (terbutaline 500 μg) were dispersed into the ELPI, NGI and eNGI, from which particle size profiles and charge profiles were ascertained. Further doses of Pulmicort and Bricanyl were fired into the eNGI at vacuum air flow rates of 45, 60, 75 and 90 L/min, and the resultant size and charge profiles were determined. Particle size profiles at 30 L/min were found to be comparable between the NGI and eNGI, while charge profiles were comparable between the eNGI and ELPI. As air flow rate increased from 30 to 90 L/min, in vitro aerosol performance improved before reaching a peak at 45 L/min (Pulmicort) and 60 L/min (Bricanyl). Net charge also increased with flow rate, the cause of which may be a combination of increased turbulence and aerosol performance. This study demonstrates that the eNGI is capable of electrostatic and particle size characterization of commercial drug-only DPI products.     

Pleomorphic xanthoastrocytoma in elderly patients may portend a poor prognosis.

Pleomorphic xanthoastrocytoma (PXA) is a rare primary astrocytic tumour of the nervous system usually involving the superficial temporal cortex of children and young adults. Although the tumour may exhibit histological features of pleomorphism or cellular atypia, the overall prognosis is good compared with other glial tumours, with only 30% of PXA recurring and 20% undergoing anaplastic transformation. Increased mitotic activity, high MIB-1 and proliferating cell nuclear antigen labelling indices and necrosis are poor prognostic factors, whereas abundant lymphocytic infiltration is associated with more benign biological behaviour. Rarely, in older patients, PXA may have a poor prognosis as these patients tend to have intracranial hypertension and focal deficits, as well as histological features of mitosis, increased cellularity and necrosis. We report the case of a 76-year-old woman who presented with dysphasia and right hemiparesis. A left fronto-temporal lobe PXA was misdiagnosed as glioblastoma multiforme. Although a rare and benign tumour type, PXA in the elderly tend to be more malignant, may have the radiological appearance of a malignant tumour and have poor prognosis.     

Genetic variants in interleukin-2 and risk of lymphoma among children in Korea

To estimate the genetic susceptibility for childhood lymphoma, we conducted an association study for 23 cases and 148 controls. Total 1536 tag single nucleotide polymorphisms (SNPs) were selected in 138 candidate gene regions related to immune responses, apoptosis, the cell cycle, and DNA repair. Twelve SNPs were significantly associated with the risk of lymphoma (P(trend)<0.05) in six genes (IL1RN, IL2, IL12RB1, JAK3, TNFRSF13B, and XRCC3). The most significant association was seen for IL2 variant rs2069762 (OR(TG+GG) vs. TT=3.43 (1.29-9.11), P(trend)=0.002, minP=0.005). These findings suggest that common genetic variants in IL2 might play a role in the pathogenesis of childhood lymphoma.     

A clinical epidemiological study in 2169 patients with vertigo

Objective

To investigate the clinical epidemiological characteristics of vertigo.

Methods

Retrospective study on 2169 patients with vertigo (male 883, female 1286, 7–90 years old) of the past 20 years.

Results

More than 50 kinds of causative diseases were recognized. Peripheral, central, and unclassified vertigo took up 33.8, 17.2 and 26.8% of patients, respectively, while vertigo of unknown origin was around 22.2%. Vertigo patients increased according to age and reached its peak in the 1960s among all three categories. Although female patients were seemingly overwhelmed the male, no significant difference in the incidence rate was recognized in two genders. Only 2.2% (48 cases) of the total vertigo patients were children, while elders occupied 30.0% (650 cases). Compared to younger patients, the elderly have a high tendency of suffering central vertigo.

Conclusion

Vertigo attacks patients in all age spans, with various causative diseases.     

Direct detection of methicillin-resistant Staphylococcus aureus from blood cultures using an immunochromatographic immunoassay-based MRSA rapid kit for the detection of penicillin-binding protein 2a

Using an EZ-Step MRSA rapid kit, a novel screening test for methicillin-resistant Staphylococcus aureus (MRSA) that detects penicillin-binding protein 2a, 34 of 36 MRSA-positive clinical blood culture samples were positive on direct testing (sensitivity, 94.4%), whereas 21 of 21 methicillin-susceptible S. aureus-positive samples were negative (specificity, 100%).     

Identification of novel candidate target genes, including EPHB3, MASP1 and SST at 3q26.2–q29 in squamous cell carcinoma of the lung

Background  

The underlying genetic alterations for squamous cell carcinoma (SCC) and adenocarcinoma (AC) carcinogenesis are largely unknown.     

Chronic peripheral administration of the angiotensin II AT1 receptor antagonist Candesartan blocks brain AT1 receptors

Brain Angiotensin II, through stimulation of brain AT₁ receptors, regulates pituitary hormones and autonomic activity. We have administered the insurmountable AT₁ antagonist Candesartan, s.c. via osmotic minipumps for 14 days, to determine whether peripheral chronic AT₁ blockade affects AT₁ receptor binding and mRNA in the brain. Peripherally administered Candesartan (0.1, 0.5 or 1.0 mg/kg per day) inhibits AT₁ binding in adrenal gland zona glomerulosa and kidney glomeruli. In addition, Candesartan dose-dependently decreases AT₁ binding in brain areas outside (subfornical organ and area postrema) and inside (paraventricular nucleus of the hypothalamus and nucleus of the solitary tract) the blood–brain barrier. Conversely, peripheral treatment with Candesartan does not affect AT_1A receptor mRNA, the predominant receptor subtype expressed in these areas, or Angiotensin II binding to AT₂ receptors in the locus coeruleus or inferior olive. Our results demonstrate that chronic peripheral treatment with selective, potent AT₁ antagonists not only inhibits peripheral but also brain AT₁ receptors. These central effects may play a role in the antihypertensive effects of the AT₁ antagonist Candesartan.